Lipid-lowering Therapy and Coronary Plaque Regression

• Published in: Journal of Atherosclerosis and Thrombosis 2024/11/01, Vol.31(11), pp.1479-1495
• Main Authors: Ueki, Yasushi, Itagaki, Tadashi, Kuwahara, Koichiro
• Format: Article
• Language: English
• Subjects: Anticholesteremic Agents - therapeutic use; Cholesterol, LDL - blood; Computed tomography; Coronary Artery Disease - diagnosis; Coronary Artery Disease - drug therapy; Ezetimibe - therapeutic use; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypolipidemic Agents - therapeutic use; Intravascular ultrasound; Lipid-lowering therapy; Near-infrared spectroscopy; Optical coherence tomography; Plaque regression; Plaque, Atherosclerotic - diagnostic imaging; Plaque, Atherosclerotic - drug therapy; Review; Tomography, Optical Coherence - methods; Ultrasonography, Interventional - methods
• ISSN: 1340-3478; 1880-3873; 1880-3873
• DOI: 10.5551/jat.RV22024

Lipid-lowering therapy plays a central role in reducing cardiovascular events. Over the past few decades, clinical trials utilizing several imaging techniques have consistently shown that lipid-lowering therapy can reduce the coronary plaque burden and improve plaque composition. Although intravascular ultrasound has been the most extensively used modality to assess plaque burden, other invasive modalities, such as optical coherence tomography and near-infrared spectroscopy, provide relevant data on plaque vulnerability, and computed tomography angiography detects both plaque volume and characteristics non-invasively. A large body of evidence supports the notion that reducing low-density lipoprotein cholesterol using statins combined with ezetimibe and proprotein convertase subtillisin/kexin type 9 inhibitors consistently shows improvements in plaque burden and favorable morphological changes. This review summarizes previously obtained data on the impact of lipid-lowering treatment strategies on atherosclerotic plaque regression, as assessed using several imaging modalities.